BACKGROUND: Flecainide is an antiarrhythmic agent that is used primarily in the treatment of cardiac arrhythmias. Some evidences also suggest that flecainide can participate in alveolar fluid clearance and inflammatory responses. This experiment was aimed to evaluate the effects of flecainide on sepsis induced acute lung injury in a rat model. METHODS: Rats were treated with subcutaneous infusion of saline or flecainide (0.1 or 0.2 mg/kg/hr) by a mini-osmotic pump. Subcutaneous infusion was started 3 hours before and continued until 8 hours after intraperitoneal injection of saline or endotoxin. Animals were sacrificed for analyses of severity of acute lung injury with wet to dry (W/D) ratio and lung injury score (LIS) in lung and inflammatory responses with level of leukocyte, polymorphonuclear neutrophils (PMNs) and inteleukin-8 (IL-8) in bronchoalveolar lavages fluid (BALF). RESULTS: Flecainide markedly improved dose dependently sepsis induced acute lung injury as analysed by W/D ratio (from 2.24 ± 0.11 to 1.76 ± 0.09, p < 0.05) and LIS (from 3 to 1, p < 0.05), and inflammatory response as determined by leukocyte (from 443 ± 127 to 229 ± 95, p < 0.05), PMNs (from 41.43 ± 17.63 to 2.43 ± 2.61, p < 0.05) and IL-8 (from 95.00 ± 15.28 to 40.00 ± 10.21, p < 0.05) in BALF. CONCLUSIONS: Flecanide improve sepsis induced acute lung injury in rats by controlling inflammatory responses.
Acute Lung Injury* ; Animals ; Arrhythmias, Cardiac ; Bronchoalveolar Lavage ; Flecainide* ; Infusions, Subcutaneous ; Injections, Intraperitoneal ; Interleukin-8 ; Leukocytes ; Lung ; Lung Injury ; Models, Animal ; Neutrophils ; Rats ; Sepsis*

This study was carried out to evaluate the relations among workers' general characteristics, work-related behaviors and health related behaviors in a steel industry with 1,134 workers in Pohang. The results were as follows; 1. The mean age of workers was 50 years old and working duration was 15 years and over. Most of them were married(94 5%) and had studied beyond high school (53.0%). They performed three shift work and most of them(63.0%) had experienced industrial accidents. The frequency of noise and dust exposure was defined by a minimum of 6 hours per day, and workers complained about noise exposure(62.9%) and dust(55.6%). There were current smokers(67.7%), current drinkers(74.3%) and current exercising workers(32.3%) in the industry. The number of cigarette consumption in current drinkers was significantly high (13.6 +/- 8.4 pieces/day) and the alcohol consumption in current smokers was significantly high(l04.5 +/- 113.5 g/wk). And the number of cigarette consumption of exercisers was significantly low and the alcohol consumption of exercisers was higher than non-exercisers. 3. The ratio of current smokers on frequent noise in exposed workers versus non-exposed workers was not significantly high but the current drinkers in frequent noise and dust exposed workers was significantly higher than non--exposed. 4. The normal levels of SGOT workers in non-smokers were significantly higher than in current smokers, and the abnormal levels of LFT(SGOT, SGPT, gamma-GTP workers in nondrinkers were significantly high. The normal levels of SBP and DBP workers in current smokers were not significantly high but were significantly high in non-drinkers. 5. The ratio of current smokers in workers unsatisfied with their job and working condition was higher than non-smokers, but the ratio of current drinkers in workers satisfied with their job and working condition were higher. 6. The significant factors for SGOT and gamma-GTP were age, the drinking amount and BMI. But the only significant factor for r-GTP was BMI. The significant factors for DBP were age, the alcohol consumption and BMI And the significant factors for SBP were age, BMI.
Accidents, Occupational ; Alanine Transaminase ; Alcohol Drinking ; Aspartate Aminotransferases ; Drinking ; Dust ; Gyeongsangbuk-do ; Health Behavior* ; Humans ; Male* ; Middle Aged ; Noise ; Smoking ; Steel* ; Tobacco Products

PURPOSE: This study was to examine the effects of hand massage and hand holding as nursing interventions on the anxiety in patients with local infiltration anesthesia. METHOD: The design of this study was a nonequivalent, control group, non- synchronized design. The subjects of this study consisted of 15 patients for the hand group, 15 patients for the hand holding group and 17 patients for the control group awaiting surgery in the operation room of a general hospitalin Daegu. As an experimental treatment, hand massage was carried out by the Hand Massage Protocol developed by Snyder(1995) and interpreted by Cho(1998) and hand holding developed by Cho(1998). The data were analyzed by SPSS/WIN, T-test, ANOVA, Cronbach's alpha, and the Scheffe test. RESULTS: The hand massage group and hand holding group were more effective than the control group in reducing anxiety, VAS score, systolic blood pressure and pulse rate. CONCLUSION: Hand massage and hand holding are effective nursing interventions that alleviates the psychological and physiological anxiety of patients with local infiltration anesthesia. In particular, the simple contact of hand holding is regarded as an effective and easily accessible nursing intervention in the operating room.
Adolescent ; Adult ; Aged ; Anesthesia, Local/*nursing ; Anxiety/*nursing ; Blood Pressure ; Female ; *Hand ; Heart Rate ; Humans ; Male ; *Massage ; Middle Aged

Clostridium difficile is the most common nosocomial pathogen of the gastrointestinal tract. Pseudomembranous colitis occurs as a result of a severe inflammatory response to Clostridium difficile toxins. Pseudomembranous colitis is an increasingly frequent cause of morbidity and mortality among elderly hospitalized patients. Diarrhea is the most common manifestation. According to the literature, stools are almost never grossly bloody, and range from soft and unformed to watery or mucoid in consistency. We now report the cases of three patients with pseudomembranous colitis whose main clinical manifestation was hematochezia.
Aged ; Clostridium difficile ; Diarrhea ; Enterocolitis, Pseudomembranous ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Humans

Interleukin-6(IL-6) stimulate osteoclast differentiation. 17beta-estradiol, 1,25-dihydroxyvitamin D3(1,25-(OH)2D3) and interleukin-1beta inhibit or stimulate osteoclast differentiation by decreasing or increasing the synthesis of interleukin-6(IL-6) from stromal/osteoblastic cells, respectively. Periodontal ligament(PDL) cells reside between the alveolar bone and the cementum and have osteoblastic characteristics. To estimate the effect of 17beta-estradiol and 1,25(OH)2D3 on IL-6 production of PDL cells, PDL cells were treated with 17beta-estradiol or 1,25-(OH)2D3 in the absence or the presence of IL-1beta. The concentration of IL-6 produced form PDL cells was determined by enzym linked immunosorbent assay(ELISA). In unstimulated PDL cells, we detected constitutive production of IL-6 at 1st and 2nd day. IL-1beta increased IL-6 synthesis at 1st day and 2nd day. 17beta-estradiol had no significant effect on the secretion of this cytokine, either constitutively or after stimulation with IL-1beta(0.05 ng/ml). 1,25-(OH)2D3(10(-8)M) decreased not only constitutive IL-6 production but also IL-1beta-induced IL-6 production at 2nd day. These results suggest that 1,25-(OH)2D3 may control IL-1beta-induced osteoclast differentiation by decreasing IL-1beta-induced IL-6 secretion of PDL cells.
Calcitriol* ; Dental Cementum ; Interleukin-1beta ; Interleukin-6* ; Osteoblasts ; Osteoclasts ; Periodontal Ligament*

BACKGROUND: Coronary artery bypass grafting without cardiopulmonary bypass (Off-Pump Coronary Artery Bypass Grafting, OPCAB) causes significant hemodynamic derangement by displacement of the beating heart. The purpose of this study was to analyze the hemodynamic changes caused in relation to grafted arteries by displacing the heart and stabilizing the coronary arteries in patients undergoing OPCAB. METHODS: Nineteen patients underwent OPCAB using two deep pericardial sutures and tissue stabilizers (Octopus Tissue Stabilization Syetem, Medtronic, USA). The hemodynamic variables were obtained after induction of anesthesia, after deep pericardial sutures, before and after anastomosis of each coronary artery during epicardial stabilizing, after sternal closure, and after postoperative 6 hours and 12 hours in the intensive care unit. RESULTS: The hemodynamic variables were maintained with the Trendelenburg position, volume loading and low dose vasopressors after deep pericardial stay sutures. Displacement of the heart and placement of the stabilizer on all coronary territories except the obtuse marginal artery before anastomosis showed no significant difference in hemodynamics compared with baseline. Positioning for the graft to the obtuse marginal artery decreased cardiac index (1.6+/-0.4 L/min/m2) and stroke index (27.6+/-9.9 L/beat/m2) and increased systemic vascular resistance (2318.9+/-673.7 dyne sec cm(-5)), resulting in hemodynamic compromise (P<0.01). There were no significant hemodynamic and electrocardiographic changes before or after grafting of other coronary arteries but there was a significant increase in cardiac index after postoperative 6 and 12 hours compared with baseline values (P<0.05). CONCLUSIONS: Although the complete revascularization of most coronary arteries is feasible on the beating heart without significant hemodynamic compromise with minimal vasopressor support, the positioning for the graft to the obtuse marginal artery needs special attention because two deep pericardial stay sutures and Octopus tissue stabilizers on the obtuse marginal artery territory induce significant hemodynamic disturbances.
Anesthesia ; Arteries ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump* ; Coronary Artery Disease ; Coronary Vessels ; Electrocardiography ; Head-Down Tilt ; Heart* ; Hemodynamics* ; Humans ; Intensive Care Units ; Octopodiformes ; Stroke ; Sutures ; Transplants* ; Vascular Resistance

There are many studies of the spousal bereavement as an important etiologic factor of depression in elders. But there are some differernt natures of spousal bereavement between the Korean and the western elderly. The problems of spousal bereavement in Korean would be more persistent than that in western. And the depressive symptoms of Korean elders are different with that of western elders due to the differences of sociocultural background. The authors studied the effect of the spousal bereavement to the depressive symptoms of elders by using KGDS (Korean Form of Geriatric Depression Scale), which already has been standardized in Korea. The subjects were consist of one hundred seventy-five, 60 years and older. The authors compared KGDS and its 5 factors in the spousal bereaved subjects group (SBG) with those in the spousal non-bereaved subjects group (SNG), and also investigated the differences according to sex and children living with the subject in the SBG. And the authors analysed the correlations between ages at spousal death, durations after spousal death and KGDS in the SBG. The mean KGDS scores in the SBG were significantly higher than that of the SNG, and especially Factor 1, Factor 2 and Factor 4 were significant. In the SBG, the mean KGDS scores of the female were significantly higher than that of the male, and especially Factor 2, Factor 3, and Factor 5 were significant. And in the SBG, the mean KGDS scores of the subjects living with children were slightly higher than those of the subjects living without children. And also in the SBG, there were negative correlations between KGDS scores and ages at spousal death, and positive correlations between KGDS scores and durations after spousal death. The authors found that the spousal bearevement could be an important etiologic factor of geriatric depression, and the risk factors of depression were female, younger at spousal death and longer duration after spousal death in bereaved elders, as the earlier studies in the western. However, the authors found that, in Korea, there were some different results from the western, such as the longer duration after spousal death and higher ratio of the widower to the widow than that in the western, the spousal bereaved elders living with children were rather depressive than who living without children.
Aged ; Bereavement ; Child ; Depression* ; Female ; Humans ; Korea ; Male ; Risk Factors ; Widowhood

The principal objective of this study was to assess the nutritional status and dietary quality in low-income elderly individuals residing at home (LH) or in health care facilities (LHCF) with dietitian. This study was conducted via anthropometric measurements, questionnaire interviews, and dietary surveys using a 24 hr recall method with 120 low-income elderly individuals (LHCF=46, LH=74). The average ages of the LH and LHCF group were 76.3 years and 78.6 years, respectively. The LH group evidenced a significantly higher frequency of skipping meals than the LHCF group. The average energy intakes of the LHCF and LH group were 1921.0 kcal and 1443.9 kcal, with a significant difference (p<0.001). Most of the nutrient intake and intake rates for recommended intake were significantly higher among the LHCF group as compared with the LH group. The LHCF group showed significantly higher values for the nutrient adequacy ratio (NAR), the mean adequacy ratio (MAR), nutrient density (ND), and the index of nutritional quality (INQ) by dietary qualitative estimation than in the LH group. The Korean diet diversity scores (KDDS) were 3.66 for LH group and 4.93 for the LHCF group, thus were significantly higher in the LHCF group than in the LH group. The results of the present study demonstrate that the LH group appeared to experience more dietary problems than the LHCF group. It was suggested that nutritional education is needed for low-income elderly individuals living at home, in order for them to learn proper dietary management. This can be achieved via educational programs in social welfare institutions, incentives toward employment as a dietitian, and implementation of community-based support.
Aged ; Delivery of Health Care ; Diet ; Employment ; Humans ; Meals ; Motivation ; Nutritional Status ; Nutritive Value ; Surveys and Questionnaires ; Social Welfare

Almost all advanced glomerular diseases have glomerular sclerotic changes to varying degrees whatever causes their primary glomerular disease are. Pathogenesis of these sclerosis has been thought of as the hyperfiltration in the primary glomerulosclerosis due to development of glomerular hypertension in each insulted glomeruli. This background gave the theoretical bases for antihypertensive therapies for supporting chronic renal insufficient patients. Angiotensin converting enzyme (ACE) inhibitor, one of the antihypertensive drugs, has received attention recently for its effectiveness. The aims of this study determined the effects and mechanism of the ACE inhibitor, enalapril, on the glomerulosclerosis in FGS/NgaKist mice, which was an animal model of chronic renal failure by generating spontaneously heavy proteinuria and progressive glomerulosclerosis. Five-week-old FGS/NgaKist mice (n=38) were assigned to four groups. Group 1a (n=6) and group 2a (n=8) fed with a vehicle, were sacrificed at the end of 10 weeks and 15 weeks, respectively. Group 1b (n=12) and 2b (n=12) received enalapril (100 mg/L) in drinking water for 5 weeks and 10 weeks from 6th week of age respectively, and were sacrified on the same day as the control groups. Doses of enanapril were maintained to 2 mg/kg/day by measuring the amount of water consumption. In enalapril groups 1b and 2b, systemic blood pressure (74.7 14.0 mm Hg, 74.3 15.9 mmHg) were significantly lower than control group 2a (116.1 4.6 mmHg, P<0.001). Similarly, degree of proteinuria lowered in enalapril group 2b versus control group 2a (0% and 50.0%, P<0.001). Glomerulosclerosis percentage significantly decreased (P<0.001) (group 1b and 2b; 1.9 6.5, 5.6 7.0 vs control 1a and 2a; 32.8 15.5, 31.4 13.8). Glomerulosclerosis score also decreased (P<0.001) (group 1b and 2b; 0.02 0.08 vs control 1a and 2a; 0.48 0.12, 0.30 0.14). The immunofluorescent staining of enalapril groups showed negative for mesangial deposition of IgG, IgA, IgM, and C3 which were positive in control groups. Immunohistochemical staining with TGF-beta1 was negative in enalapril groups and sclerotic glomeruli both enalapril groups and control groups. These results support that the ACE inhibitor has a renoprotective effect on glomerulosclerosis not only by decreasing the blood pressure but also by suppressing the immune deposits on glomeruli.
Angiotensins* ; Animals ; Antihypertensive Agents ; Blood Pressure ; Drinking ; Drinking Water ; Enalapril ; Humans ; Hypertension ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Kidney Failure, Chronic ; Mice ; Models, Animal ; Peptidyl-Dipeptidase A* ; Proteinuria ; Sclerosis* ; Transforming Growth Factor beta1

PURPOSE: The prevalence of chronic critical limb ischemia has been increased significantly due to the increased incidence of atherosclerosis obliterans in Korea. Higher rates of lower extremity amputation, along with increased incidence and severity of coronary artery disease are well recognized in diabetic patients and may discourage any aggressive treatment in these patients. To determine the role of diabetes mellitus(DM) in graft outcome of peripheral arterial occlusive disease in our patient population, diabetic patients who underwent bypass were reviewed. METHOD: Thirty-two patients who underwent 37 arterial bypass grafts (operated group) and 42 patients who were admitted to our center for arterial occlusive disease (non-operated group) from March 1999 to December 2002 were reviewed retrospectively. The operated group was divided into two subgroups: DM (15 bypasses) and non-DM (22 bypasses). Primary patency rates of arterial bypass graft and postoperative ankle brachial index were compared. RESULT: Most patients were males (93.7% in operated group, 90.4% in non-operated group), and peak incidence was in the seventh decade. The risk factors were male sex (90.5%), smoking history (58.2%), hypertension (39%), DM (37.8%) and old age (>70 years, 27%). Primary cumulative graft patency rates at 2 months were 93.9% and 95.2% in DM and non-DM patients, respectively. Primary cumulative graft patency rates at 2 years were 70.2% and 71.2% in DM and non-DM patients, respectively, and there was no statistical difference between the two groups. CONCLUSION: Arterial bypass grafting for peripheral arterial occlusive disease can be performed successfully in diabetic patients with a comparable patency rate to those without DM, and more a aggressive approach including bypass grafting should be undertaken to achieve limb salvage in the diabetic population for their improved quality of life.
Amputation ; Ankle Brachial Index ; Arterial Occlusive Diseases* ; Atherosclerosis ; Coronary Artery Disease ; Diabetes Mellitus* ; Extremities ; Humans ; Hypertension ; Incidence ; Ischemia ; Korea ; Limb Salvage ; Lower Extremity ; Male ; Prevalence ; Quality of Life ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Transplants*